Constipation: A Pain in the Butt!

Did you know that over 20% (and very likely more!) of Americans are affected by constipation? Difficulty pooping affects so many people, and pelvic floor therapy can help you with this!

Our pelvic floor PTs at Foundations Pelvic Health can help with so much more than urinary or pregnancy and postpartum concerns - we can help with your bowel issues as well. While the root cause of constipation can be complex and multi-faceted, we help many people figure out what’s going on with their bowel movements.

What’s Considered Normal?

Everybody has their own version of normal when it comes to pooping. Bowel movements can occur anywhere from 3x/day to 3x/week - what matters is what’s normal for YOU. However, all bowel movements should be:

  • pain-free

  • not require straining

  • Type 3 or 4 on the Bristol Stool Chart

Symptoms of Constipation:

Constipation can be very uncomfortable, especially if bowel movements are happening less than 3x/week. Symptoms may include:

  • feelings of incomplete emptying

  • the need to strain on the toilet

  • stools that are lumpy or pebbles (Bristol Stool Chart types 1 and 2).

  • As a result of chronic constipation, you may also experience bloating, hemorrhoids, pain with bowel movements, nausea, cramping, or abdominal pain

Pelvic Floor Therapy for Constipation:

The pelvic floor muscles can also be a main contributor to constipation. One of the primary roles of the pelvic floor is to assist with urination and passing stools, and sometimes your pelvic floor can have issues with this.

Your pelvic floor may be too tight

The pelvic floor must be able to relax, effectively getting out of the way, to allow a bowel movement to pass. If your muscles are too tight, it will be increasingly difficult to poop. Pain with pooping can also cause increased muscle tightness as your body might clench more due to the pain.

Your PT can help release the muscles and teach you relaxation strategies to help. Even simple strategies such as proper positioning on a Squatty Potty can help relax your pelvic floor!

Your pelvic floor muscles aren’t relaxing at the right time 

Sometimes it may feel like you’re relaxing or pushing effectively while pooping, when in actuality your muscles are tightening! The coordination and timing of your muscles can be off, which can make it harder for you to have a complete bowel movement. Through training exercises, your PT can help determine if this is happening and help retrain the pelvic floor to relax when it needs to. 

Pelvic Health Education for Constipation:

Our pelvic floor PTs also educate our patients on other contributing factors to patients. We may recommend abdominal massage, drinking more water, incorporating more exercise, or introduce a bowel routine to help your bowels recognize the appropriate sensations when you have the urge to pop.

We can also provide you with ways to improve your posture on the toilet and ways to effectively bear down to make it easier to have a bowel movement. 

Other Causes of Constipation:

Our pelvic floor PTs can help guide you to determine why constipation may be occurring. We often collaborate with other healthcare providers like GI specialists, nutritionists/dietitians, acupuncturists, and functional medicine providers. Possible causes of your constipation may include: 

  • Diet: lack of fiber, certain foods

  • Dehydration

  • Decreased physical activity

  • Ignoring the urge to go

  • Stress

  • Changes in routine or travel 

  • Medications or vitamin deficiencies

  • Hormone changes (throughout the menstrual cycle, pregnancy, lactation, menopause) 

  • Other colorectal conditions 

Other Common Bowel Conditions Pelvic Floor PTs Help

  • Incomplete Emptying

  • Fecal Incontinence

  • Hemorrhoids 

  • Rectal Pain

  • Anal Fissures 

  • Back and Tailbone Pain

As you see above, constipation can be complex and affect each person differently. Your pelvic floor physical therapist at Foundations Pelvic Health will be able to help you manage your constipation so you get rid of this pain in your butt!


Hi! We are Boston’s pelvic floor physical therapy experts specializing in helping you with all things bladder, bowel, sexual dysfunction, and we are also your pregnancy and postpartum specialists.

If you have questions about pelvic floor physical therapy or if you’re struggling with pelvic floor issues related to constipation, we’d love to help you at Foundations Pelvic Health - located in the South End of Boston, MA.


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